Displaying all 15 publications

Abstract:
Sort:
  1. Chew BH, Lee PY, Ismail IZ
    Malays Fam Physician, 2014;9(2):26-33.
    PMID: 25893068
    BACKGROUND: Personal mission in life can determine the motivation, happiness, career advancement and fulfilment in life of the medical students (MSs) along with improvement in professional/clinical performance of the family physicians. This study explored the personal beliefs, values and goals in the lives of MSs and general practitioners (GPs).
    METHODS: Fourth-year MSs at the Universiti Putra Malaysia and GPs who participated in a 2-hour session on 'Ethics in Family Medicine' in 2012 were invited. All the participants submitted the post-session written reflections about their personal missions in life. The written reflections were analysed using thematic analysis.
    RESULTS: A total of 87 MSs and 31 GPs submitted their written reflections. The authors identified 17 categories from the reflections contained by four themes-good vs. smart doctor, professional improvement vs. self-improvement, self-fulfilment and expressed motivation. The most common categories were "to be a good doctor" (97/330) and "professional improvement" (65/330). Many MSs had expressed motivation and wanted to be a smart doctor as compared to the GPs, whereas a larger number of GPs wished to have a fulfilled life and be a good doctor through professional improvement.
    CONCLUSION: The difference between the two student groups might indicate different levels of maturity and life experiences. Medical teachers should engage students more effectively in orientating them towards the essential values needed in medical practice.
    KEYWORDS: Concept formation; education; goals; medical; medical students general; practitioners; professional; values of life
  2. Manaf RA, Ismail IZ, Latiff LA
    Glob J Health Sci, 2012 Sep;4(5):91-9.
    PMID: 22980381 DOI: 10.5539/gjhs.v4n5p91
    INTRODUCTION: Women with chronic medical conditions are at higher risk of adverse pregnancy outcomes, which may be minimized through optimal preconception care and appropriate contraceptive use. This study aimed to describe contraceptive use among women with chronic medical conditions and factors associated with its non-use.
    METHODS: This study used cross-sectional data from a family planning survey among women with chronic medical conditions conducted in three health facilities in a southern state of Malaysia. A total of 450 married women in reproductive age (18-50 year) with intact uterus, and do not plan to conceive were analysed for contraceptive use. Both univariate and multivariate analysis was conducted to identify factors associated with contraceptive non-use among the study participants.
    RESULTS: A total of 312 (69.3%) of the study participants did not use contraceptive. Contraceptive non-use was highest among the diabetics (71.2%), connective tissue disease patients (68.6%) and hypertensive patients (65.3%). Only 26.3% of women with heart disease did not use contraceptive. In the multivariate analysis, contraceptive non-use was significantly more common among women who received their medical treatment in the health clinics as compared to those who received treatment in the hospital (adjusted odds ratio [OR]=1.75, 95% confidence interval [CI]: 1.09, 2.79), being in older age group of 41-50 year (adjusted OR=2.31, 95% CI: 1.19, 4.48), having children (adjusted OR=4.57, 95% CI: 1.66, 12.57) and having lower education (adjusted OR=2.87, 95% CI: 1.43, 5.77).
    CONCLUSION: About two-third of women with chronic medical conditions who needed contraceptive did not use them despite the higher risk of pregnancy related complications. The high unmet need warrant an effective health promotion programme to encourage the uptake of contraceptives especially targeting women of older age group, low education and those who received their medical treatment at health clinics.
    Study site: Outpatient clinic, three hospitals; 8 health clinics, Malaysia
  3. Chew B, Ramli A, Omar M, Ismail I
    Malays Fam Physician, 2013;8(2):15-25.
    PMID: 25606277 MyJurnal
    AIM: This study aimed to examine the relationship between personal or work-based characteristics and job satisfaction and motivation in Malaysian primary healthcare professionals.

    METHODS: This was a cross-sectional survey conducted during the 15th Family Medicine Scientific Conference in June 2011 using the Warr-Cook-Wall scales. The questionnaires included demography and work-related items and were self-distributed and returned at the end of the conference. Independent risk factors were identified using multiple linear regressions.

    RESULTS: A total of 149 conference participants completed the survey, with a response rate of 33.1%. They were mainly females (85.2%), Malay (83.2%), and married (83.9%) in almost equal proportions of practice location (urban 57.8% and rural 42.2%). Majority of them were working at community-based health clinics (74.0%) and in public sectors (94.4%). The respondents were mainly doctors (91.4%). The mean age of the participants was 39.1 years (SD 8.0), with a mean duration of service of 9 years (SD 6.9). Family medicine specialty (FMSt) residents had lower job satisfaction (B = -8.0, 95% CI -14.61 to -1.40, p = 0.02). Family medicine specialists (FMSs) had higher satisfaction with working conditions (B = 1.95, 95% CI 0.50 to 3.41, p = 0.01). A male worker had on average 2.8 (95% CI -4.7 to -0.9, p = 0.005) lower points in the total intrinsic job motivation scale. There was a positive relationship between the duration of working and job motivation (B = 0.10, 95% CI 0.004 to 0.2, p = 0.04).

    CONCLUSION: FMSt residents might have the least job satisfaction, but FMSs were generally satisfied with their working conditions regardless of the location of their clinics. Men and those who were novice in primary healthcare may need more support for motivation.

  4. Akhtari-Zavare M, Juni MH, Said SM, Ismail IZ
    Asian Pac J Cancer Prev, 2013;14(1):57-61.
    PMID: 23534796
    BACKGROUND: Breast cancer is the most common cancer and the second principal cause of cancer deaths among women worldwide, including Malaysia.

    METHODS: A cross-sectional study was carried out among 262 female undergraduate students in University Putra Malaysia using a validated questionnaire which was developed for this study.

    RESULTS: The mean age of respondents was 22∓2.3 years. Most of them were single (83.1%), Malay (42.3%) and 20.7% reported having a family history of breast cancer. Eighty-seven (36.7%) claimed they had practiced BSE. Motivation and self-efficacy of the respondents who performed BSE were significantly higher compared with women who did not (p<0.05).There was no association between BSE practice and demographic details (p<0.05). Logistic regression analysis indicated that women who perceived greater motivation (OR=1.089, 95%CI: 1.016-1.168) and had higher confidence of BSE (OR=1.076, 95%CI: 1.028-1.126) were more likely to perform the screening.

    CONCLUSIONS: The findings show that Malaysian young female's perception regarding breast cancer and the practice of BSE is low. Targeted education should be implemented to improve early detection of breast cancer.
  5. Akhtari-Zavare M, Juni MH, Ismail IZ, Said SM, Latiff LA
    Springerplus, 2015;4:692.
    PMID: 26587360 DOI: 10.1186/s40064-015-1491-8
    Breast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia.
  6. Akhtari-Zavare M, Lattif LA, Juni MH, Md Said S, Ismail IZ
    J Obstet Gynaecol Res, 2015 Dec;41(12):1982-7.
    PMID: 26554636 DOI: 10.1111/jog.12819
    Abstract
    AIM:
    Breast cancer is the most common cancer among women worldwide, including Malaysia. In developing countries, predictors affecting breast self-examination (BSE) practice are different. This cross-sectional study was conducted to determine the prevalence of BSE practice and the predictors affecting BSE practice among undergraduate female students in Klang Valley, Malaysia.

    MATERIAL AND METHODS:
    A cross-sectional study was conducted among 820 female undergraduate students to assess the BSE performance and related determinants of BSE practice in Klang Valley, Malaysia. Data were collected via a self-administered structured questionnaire that was developed for this study.

    RESULTS:
    The mean age of the respondents was 21.7 ± 1.2 years old. Most of them were single (96.8%), Malay (91.9%) and 19.6% of the participants performed BSE regularly. Multivariate logistic regression modeling revealed that BSE performance was more likely among women who have checked their breast with a doctor (odds ratio = 2.04, P = 0.00), and women who have personal history of breast disease (odds ratio = 4.43, P = 0.03).

    CONCLUSION:
    The findings showed a low BSE practice rate among young Malaysian women. Hence, the community's breast health awareness is needed to improve breast cancer prevention among young Malaysian women.

    KEYWORDS:
    Malaysia; breast self-examination; predictors
  7. Akhtari-Zavare M, Latiff LA, Juni MH, Said SM, Ismail IZ
    Asian Pac J Cancer Prev, 2015;16(15):6231-5.
    PMID: 26434821
    BACKGROUND: In Malaysia, breast cancer is the first cancer among females regardness of race.

    AIM: The purpose of this study was to identify the knowledge and BSE practice among undergraduate female students at four public universities in Klang Valley, Malaysia.

    MATERIALS AND METHODS: This cross-sectional study was conducted among 820 undergraduate female students using a self-administered questionnaire covering socio-demographic data, knowledge of breast cancer and BSE practice.

    RESULTS: The mean age of the respondents was 21.7±1.2 years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family history of breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination among participants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination was significantly associated with BSE practice (p=0.00). Also, there were significant associations between performing BSE with age, marital status and being trained by a doctor for doing BSE (p<0.05).

    CONCLUSIONS: Our findings showed that the rate of BSE practice and knowledge of breast cancer is inadequate among young Malaysian females. A public health education program is essential to improve breast cancer prevention among this group.
  8. Akhtari-Zavare M, Juni MH, Ismail IZ, Said SM, Latiff LA
    Asian Pac J Cancer Prev, 2015;16(9):4019-23.
    PMID: 25987079
    BACKGROUND: Breast cancer is the most frequently occurring cancer in women and the most common cause of cancer death worldwide.

    MATERIALS AND METHODS: A cross-sectional study was carried out among 792 female undergraduate students in public universities in Klang Valley, Malaysia, from January to April 2011. Data were collected using a validated questionnaire developed for this study.

    RESULTS: The mean age of respondents was 21.7±1.2 years. Most of them were single (96.8%), Malay (91.9%) and 150 (19.6%) claimed they had practiced BSE. There was a significant differences between performers and non-performers correlated to age, marital status, check breast by doctor, and being trained about BSE. Performers had lower mean scores for perceived barriers and susceptibility and higher mean score for confidence. Stepwise logistic regression analysis yielded four significant predictor variables.

    CONCLUSIONS: Overall our findings indicate that the practice of BSE while perceived as being important is not frequently practiced among female in Malaysia. Targeted education should be implemented to improve early detection of breast cancer.
  9. Akhtari-Zavare M, Juni MH, Said SM, Ismail IZ, Latiff LA, Ataollahi Eshkoor S
    BMC Public Health, 2016 08 08;16:738.
    PMID: 27502284 DOI: 10.1186/s12889-016-3414-1
    BACKGROUND: Breast cancer is the most common cancer and the second principal cause of cancer deaths in women worldwide as well as in Malaysia. Breast self-examination (BSE) has a role in raising breast cancer awareness among women and educational programs play an important role in breast cancer preventive behavior. The aim of this study is to develop, implement and evaluate the effectiveness of Breast Health Awareness program based on health belief model on knowledge of breast cancer and breast-selfexamination and BSE practice among female students in Malaysia.

    METHODS: A single-blind randomized controlled trial was carried out among 370 female undergraduate students from January 2011 to April 2012 in two selected public universities in Malaysia. Participants were randomized to either the intervention group or the control group. The educational program was delivered to the intervention group. The outcome measures were assessed at baseline, 6, and 12 months after implementing the health educational program. Chi-square, independent samples t-test and two-way repeated measures ANOVA (GLM) were conducted in the course of the data analyses.

    RESULTS: Mean scores of knowledge on breast cancer (p<0.003), knowledge on breast self examination (p<0.001), benefits of BSE (p<0.00), barrier of BSE (0.01) and confidence of BSE practice (p<0.00) in the intervention group had significant differences in comparison with those of the control group 6 and 12 months after the intervention. Also, among those who never practiced BSE at baseline, frequency of BSE practice increased 6 and 12 months after the intervention (p<0.05).

    CONCLUSION: The Breast Health Awareness program based on health the belief model had a positive effect on knowledge of breast cancer and breast self-examination and practice of BSE among females in Malaysia.

    TRIAL REGISTRATION: The ANZCTR clinical trial registry ( ACTRN12616000831482 ), retrospectively registered on Jun 23, 2016 in ANZCTR.org.au.

  10. Abdullah F, Han TM, Mat Nor MB, Mohd Aznan MA, Ismail IZ
    MyJurnal
    Introduction: Hypertension (HPT) is the most common co-morbidity among type-2 diabetes mellitus (T2DM) patients which ominously increased their morbidity and mortality from cardiovascular diseases (CVD). We aimed to determine the prevalence and control status of HPT, and also the glycemic control among T2DM patients in a primary care clinic in Kuantan, Pahang. Methods: It was a retrospective study of 154 T2DM patients’ records, aged ≥18 years selected by random sampling. The statistical analysis is done by using Chisquare test, paired sample “t” test and ANOVA “F” test. Results: Among T2DM patients; 47% were Malay, 45% Chinese and 9% Indian. The prevalence of HPT was 72.1% and majority of T2DM patients were women (60%). Out of 82 T2DM aged >60 years, 80.5% were hypertensive. 67.2% of T2DM patients between the age of 40-60 years and 25% age <40 years were also hypertensive (p= 0.003). BP-controlled status were classified into controlled, uncontrolled, systolic and diastolic HPT. All patients were compared between the last visit and one year before, which reported 55.8% versus 33.1%, 14.9% versus 51.9%, 20.1% versus 10.4% and 9.1% versus 4.5% respectively. There were significant rises in percentage of systolic BP (by 9.7%) and diastolic HPT (by 4.6%) p<0.0001, from the first visit. BP controlled status for aged group >60 years showed increments in systolic HPT and diastolic HPT which were significant (p<0.0001). Regarding glycemic parameters, 71.4% T2DM patients had poor controlled level of Hb1Ac (≥6.5) and only 20.1% remained controlled after one year (p<0.0001). Conclusions: This pilot study found high prevalence of HPT, increasing prevalence of systolic HPT and diastolic HPT in older age group as well as poor glycemic control among T2DM patients.

    KEYWORDS: Controlled blood pressure, systolic hypertension, diastolic hypertension, HbA1C difference, primary care clinic
  11. Mohd Azlan S, Mohamad F, Dahlan R, Ismail IZ, Kadir Shahar H, Kamaruddin KN, et al.
    PMID: 38496770 DOI: 10.51866/oa.34l
    INTRODUCTION: Mental health disorders (MHDs) are a global health burden with an increasing prevalence. During the COVID-19 pandemic, depression was the commonest MHD, followed by anxiety and stress. This nationwide study aimed to determine the prevalence and associated factors of depression, anxiety and stress among Malaysian students attending higher educational institutions.

    METHODS: A cross-sectional study was conducted from June to December 2021. Institutions were selected via stratified random sampling and students via convenience sampling. A self-administered questionnaire comprising questions on socio-demographic characteristics, academic background, substance abuse, childhood abuse, religiosity and the Depression Anxiety Stress Scale-21 was used. Data were analysed using SPSS version 27; descriptive, point-biserial correlation, chi-square and multiple binary logistic regression analyses were conducted.

    RESULTS: Sex and adverse childhood experiences significantly predicted all three MHDs (P<0.05). The students from public institutions (odds ratio [OR]=0.71, 95% confidence interval [CI]=0.56-0.90, P=0.004) had a lower risk of depression than those from private institutions. The smokers/vapers (OR=1.43, 95% CI=1.02-2.02, P=0.041) a higher risk of depression than the non-smokers/non-vapers. The social science students (OR=1.29, 95% CI= 1.01-1.65, P=0.039) had a higher risk of anxiety than the science students. The students who highly engaged in organisational religious activity (OR=0.91, 95% CI=0.84-0.98, P=0.015) had a lower risk of anxiety than their counterparts.

    CONCLUSION: Anxiety is the commonest MHD among Malaysian youth, followed by depression and stress. Childhood abuse is a crucial related factor requiring further attention. Screening, surveillance, preventive measures and comprehensive interventions for MHDs should be initiated among youth.

  12. Tong SF, Ng CJ, Lee VKM, Lee PY, Ismail IZ, Khoo EM, et al.
    PLoS One, 2018;13(4):e0196379.
    PMID: 29694439 DOI: 10.1371/journal.pone.0196379
    INTRODUCTION: The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs' decision-making process to participate in research.
    METHODS: We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities. Five in-depth interviews and four focus group discussions were conducted among 21 GPs. Purposeful sampling followed by theoretical sampling were used to attempt saturation of the core category. Data were collected using semi-structured open-ended questions. Interviews were recorded, transcribed verbatim and checked prior to analysis. Open line-by-line coding followed by focus coding were used to arrive at a substantive theory. Memoing was used to help bring concepts to higher abstract levels.
    RESULTS: The GPs' decision to participate in research was attributed to their inner drive and appreciation for primary care research and their confidence in managing their social and research environments. The drive and appreciation for research motivated the GPs to undergo research training to enhance their research knowledge, skills and confidence. However, the critical step in the GPs' decision to participate in research was their ability to align their research agenda with priorities in their social environment, which included personal life goals, clinical practice and organisational culture. Perceived support for research, such as funding and technical expertise, facilitated the GPs' participation in research. In addition, prior experiences participating in research also influenced the GPs' confidence in taking part in future research.
    CONCLUSIONS: The key to GPs deciding to participate in research is whether the research agenda aligns with the priorities in their social environment. Therefore, research training is important, but should be included in further measures and should comply with GPs' social environments and research support.
  13. Sobri NHM, Ismail IZ, Hassan F, Papachristou Nadal I, Forbes A, Ching SM, et al.
    BMJ Open, 2021 08 26;11(8):e044878.
    PMID: 34446477 DOI: 10.1136/bmjopen-2020-044878
    INTRODUCTION: Women who develop gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes, and to reduce this risk the women have to adopt healthy behaviour changes. Although previous studies have explored the challenges and facilitators to initiate behaviour change among women with GDM, there is limited data from Malaysian women. Thus, this study will explore the factors affecting the uptake of healthy behaviour changes and the use of digital technology among women and their healthcare providers (HCPs) to support healthy behaviour changes in women with GDM.

    METHODS AND ANALYSIS: The study will be modelled according to the Capability, Opportunity, Motivation and Behaviour and Behaviour Change Wheel techniques, and use the DoTTI framework to identify needs, solutions and testing of a preliminary mobile app, respectively. In phase 1 (design and development), a focus group discussion (FGDs) of 5-8 individuals will be conducted with an estimated 60 women with GDM and 40 HCPs (doctors, dietitians and nurses). Synthesised data from the FGDs will then be combined with content from an expert committee to inform the development of the mobile app. In phase 2 (testing of early iterations), a preview of the mobile app will undergo alpha testing among the team members and the app developers, and beta testing among 30 women with GDM or with a history of GDM, and 15 HCPs using semi-structured interviews. The outcome will enable us to optimise an intervention using the mobile app as a diabetes prevention intervention which will then be evaluated in a randomised controlled trial.

    ETHICS AND DISSEMINATION: The project has been approved by the Malaysia Research Ethics Committee. Informed consent will be obtained from all participants. Outcomes will be presented at both local and international conferences and submitted for publications in peer-reviewed journals.

  14. Benton M, Iman I, Goldsmith K, Forbes A, Ching SM, Papachristou Nadal I, et al.
    JMIR Res Protoc, 2022 Sep 08;11(9):e37288.
    PMID: 36074545 DOI: 10.2196/37288
    BACKGROUND: Over 50% of women with a history of gestational diabetes mellitus (GDM) will develop type 2 diabetes (T2D) in later life. Asian women experience a disproportionate risk of both GDM and T2D compared to women from other ethnic backgrounds. Lifestyle interventions and behavior change can delay or even prevent the onset of T2D. We have developed a digitalized diabetes prevention intervention for the prevention of T2D in Malaysian women with GDM.

    OBJECTIVE: The protocol describes a randomized controlled trial (RCT) to test the feasibility of undertaking a definitive trial of a diabetes prevention intervention, including a smartphone app and group support. Secondary aims are to summarize anthropometric, biomedical, psychological, and lifestyle outcomes overall and by allocation group, and to undertake a process evaluation.

    METHODS: This is a two-arm parallel feasibility RCT. A total of 60 Malaysian women with GDM will be randomized in the antenatal period to receive the intervention or standard care until 12 months post partum. The intervention is a diabetes prevention intervention delivered via a smartphone app developed based on the Information-Motivation-Behavioral Skills model of behavior change and group support using motivational interviewing. The intervention provides women with tailored information and support to encourage weight loss through adapted dietary intake and physical activity. Women in the control arm will receive standard care. The Malaysian Ministry of Health's Medical Research and Ethics Committee has approved the trial (NMRR-21-1667-60212).

    RESULTS: Recruitment and enrollment began in February 2022. Future outcomes will be published in peer-reviewed health-related research journals and presented at national, regional, or state professional meetings and conferences. This publication is based on protocol version 2, January 19, 2022.

    CONCLUSIONS: To our knowledge, this will be the first study in Malaysia that aims to determine the feasibility of a digital intervention in T2D prevention among women with GDM. Findings from this feasibility study will inform the design of a full-scale RCT in the future.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT05204706; https://clinicaltrials.gov/ct2/show/NCT05204706.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/37288.

  15. Ching SM, Cheong AT, Yee A, Thurasamy R, Lim PY, Ismail IZ, et al.
    PMID: 37814673 DOI: 10.51866/oa.238
    INTRODUCTION: Malaysia is one of the hardest-hit countries by COVID-19 in Asia. The rapidly rising number of cases had sparked fear among healthcare providers. This study aimed to assess the determinants of fear towards COVID-19 among healthcare providers in primary care settings.

    METHOD: This online-based cross-sectional study was conducted among 1280 healthcare providers aged ≥18 years from 30 primary care clinics in the state of Selangor, Malaysia. The Fear of COVID-19 Scale was used to assess the level of fear, and the results were analysed using multiple linear regression.

    RESULTS: The mean age of the respondents was 36 years, and the mean working experience was 11 years. The majority of the respondents were women (82.4%) and Malays (82.3%). The factors that were significantly correlated with higher levels of fear were underlying chronic disease (ß=1.12, P=0.002, 95% confidence interval [CI]=0.08, 3.15), concern about mortality from COVID-19 (ß=3.3, P<0.001, 95% CI=0.19, 7.22), higher risk of exposure (ß=0.8, P<0.001, 95% CI=0.14, 5.91), concern for self at work (ß=2.8, P=0.002, 95% CI=0.08, 3.10) and work as a nurse (ß=3.6, P<0.001, 95% CI=0.30, 7.52), medical laboratory worker (ß=3.0, P<0.001, 95% CI=0.12, 4.27) and healthcare assistant (ß=3.9, P<0.001, 95% CI=0.17, 5.73). The level of fear was inversely correlated with a higher work-related stress management score (ß=-0.9, P<0.001, 95% CI=-0.14, -5.07) and a higher sleep quality score (ß=-1.8, P<0.001, 95% CI=-0.28, -10.41).

    CONCLUSION: Family physicians should be vigilant and identify healthcare providers at risk of developing COVID-19-related fear to initiate early mental health intervention.

Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links